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Besut Daryanto
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Department of Urology, Faculty of Medicine, Universitas Brawijaya Gedung Pendidikan Terpadu 2 Lt 4, Jalan Jaksa Agung Suprapto No. 2, Malang 65111
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Brawijaya Journal of Urology
Published by Universitas Brawijaya
ISSN : 27214982     EISSN : 27224546     DOI : https://doi.org/10.11594/bjurology
Core Subject : Health,
Health Professions Medicine & Pharmacology
Brawijaya Journal of Urology conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. To guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. All manuscripts are subject to peer review and are judged based on their contribution of original data and ideas or interpretation. Subject areas of the journal include andro-urology, anesthesiology, biomedicine, BPH, cancer and stem cells, cell and molecular biology, female and neuro-urology, geriatrics, histopathology, internal medicine, kidney transplant, pediatric urology, pharmacology, physio-pharmacology, radiology, stones, trauma and reconstruction of urethra, uro-oncology.
Arjuna Subject : Kedokteran - Urologi
Articles 35 Documents
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Quality of Life in Cervical Cancer Patients who Underwent Desobstruction Procedures
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Abstract

Objective: Obstructive uropathy is a common condition in hospitalized cervical cancer patients. Many patients underwent surgical procedures to improve their QoL. This study was aimed to compare the quality of life (QoL) and Survival Rate in cervical cancer with obstructive uropathy pre and post operative in the Urology Department at Saiful Anwar General Hospital from July 2016 to August 2017. Materia and Method: 75 patients with obstructive uropathy in cervical cancer underwent desobstruction procedures. Inclusion criteria was patient with bilateral or unilateral hydronephrosis. Exclusion criteria where patients who loss of follow up. QoL was assessed using WHO QoL-BREF which has 4 domains; (I:physical health, II: physiologic health, III: social relationships and IV: environmental health). The results before and after procedure were compared using Mann Whitney in a prospective manner. Result: From 75 patients, 64 cases had bilateral obstruction and 11 cases had unilateral obstruction. 43 (57%) patients underwent desobstruction procedures as follows: retrograde DJ stent in 31 patients; internal ureteral DJ stent in 2 patients; ureterocutaneostomy in 9 patients; percutaneous nephrostomy in 1 patient. There are 32 patients without desobstruction procedures. Result showed that patient’s QoL in the domain I to IV were significantly decreased in 6 months and 1 year follow up period. There was no significant difference of QoL between all surgical procedures (p=0.872). The survival rate between retrograde diversions and open diversions were not significantly different (p=1.356). Concluison: Desobstructions procedure did not improve QoL in cervical cancer patients with obstructive uropathy at 6 months and one year follow up period.
Hemodynamic Instability and Severity Grade of Kidney Trauma as The Predictor Factors for Nephrectomy Besut Daryanto; I Gusti Lanang Andi Suharibawa; Kurnia Penta Seputra; Paksi Satyagraha; Pradana Nurhadi
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Abstract

Introduction: Kidney trauma occurs in presumably 1-5% of all trauma cases. Delayed surgery increases the likelihood of persistent urinary extravasation and secondary hemorrhage, whereas immediate surgery results in a high renal loss. Hence, the aims sought to evaluate whether hemodynamic instability, urea and creatinine level, anemia and severity grading of kidney trauma can be the predictor factors of nephrectomy. Materials and Methods: Retrospectively study from January 2005 to December 2016, the authors collected the data of 63 kidney trauma patients. We analyzed the hemodynamic condition, hemoglobin level, and grade of kidney injury. The association of hemodynamic instability, urea and creatinine level, anemia, grade of kidney injury to the decision of nephrectomy were analyzed using statistical software (SPSS). Results: Kidney trauma occurred mostly in first grade (40/63.5%). Only 4 (5.4%) came in high grade of renal trauma (Grade III and IV). Patients who came to the emergency department mostly in stable hemodynamic (52/82.5%). Most of them were subsequently treated uneventfully with non-operative management (60/95.2%). There was a significant association between hemodynamic instability and treatment options that unstable hemodynamic significantly increase nephrectomy rate (p=0.047). The data analysis results associated severe grade of trauma with an increase nephrectomy rate (RR: 174, 95% CI:8.62 – 315.174, p<0.01). Further, there were no significant association between anemia, urea and creatinine levels to nephrectomy rate (p>0.05). Conclusion: Severity grade of kidney trauma and hemodynamic instability increased the risk of nephrectomy. Other factors such as anemia, urea and creatinine levels do not have a significant association with the risk of nephrectomy.
Comparison Between Gemcitabine-Cisplatin Chemotherapy Outcome and Body Mass Index in Muscle Invasive Bladder Cancer Patients At Dr. Saiful Anwar General Hospital Malang, Indonesia Kurnia Penta Seputra; Besut Daryanto; Astarin Ardiani
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Abstract

Introduction: Malignancy remain a worldwide challenge to overcome, one of the most common malignancy in men is bladder cancer, it represent the seventh most common cause of cancer in men worldwide. Over the past decade 6978 Indonesian were diagnosed with bladder cancer. In Dr. Saiful Anwar Hospital itself, 287 inpatient were hospitalized due to bladder cancer over the past 5 years. Bladder cancer therapy including, radical cystectomy, radiotherapy and chemotherapy depending on the tumor’s stage. Patients requiring chemotherapy, are given six course of Gemcitabine-Cisplatin regiment. Body Mass Index (BMI) acclaimed to take part in cancer treatment outcome, therefore this study aimed to compared body mass index with bladder tumor outcome in bladder cancer patients receiving six course of Gemcitabine-Cisplatin chemotherapy. Method: Fifteen bladder cancer patients with different BMI underwent (transurethral resection of bladder tumor) TURBT staging and received six course of Gemcitabine-Cisplatin Chemotherapy from 2016 to 2018 at Dr. Saiful Anwar General Hospital were recorded, we followed the patients during the six course of chemotherapy and evaluation were carried out using cystoscopy and bladder biopsy. The data then analysed using chi square and t-test to compared. Result: Fifteen patients were eligible for this study, 10 were men and 5 were women. Mean age is 66.6 years old, body mass index (BMI) include normal weight (73.3%), underweight (6.67%), overweight(13.3%) and obese (6.67%). Pathology finding including Transitional Cell Carcinoma of high grade (46,7%) and low grade (53.3%). Tumor staging start from T2 (26.67%), T3 (6.67%) and T4 (66.66%). Three patients had metastatic tumor to the liver, liver and lung and rectum respectively. Lymph node involvement were N0 40%(6),N1 33.3% (5) N2 20%(3) and N3 6.7% (1) continuously. Out of fifteen patients who underwent Gemcitabine-Cisplatin chemotherapy for six series, tumor outcome after therapy was compared with the BMI. Tumor still remain in 11 patient (73.3%), while 4 (26.7%) patients were found to be tumor free after six course of Gemcitabine-Cisplatin chemotherapy. There is no statistically significant between body mass index and chemotherapy success rate (p= 0.159) in this study. Although. there were statistically significant found in the presence of tumor before and after Gemcitabine-Cisplatin chemotherapy (p= 0.041). There are no statistically significant between sex and age when compared to chemotherapy outcome with (p=0.446) and (p=0.469) respectively. Conclusion: Body Mass Index has no relation in determining success rate of bladder cancer chemotherapy using Gemcitabine-Cisplatin.
Urine Metabolite Risk Factors of DJ Stent’s Biofilm Formation in Patients with Urinary Tract Stones Besut Daryanto; Muhammad Miftahul Firdaus
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Abstract

Introduction: Since first introduced by Finney and Hepperlen in 1978, the Double-J "DJ" Stent has become a routine armament that every Urologist uses everyday. Over time, there have been developments and improvements in both designs and materials, in order to improve the efficacy of the stents themselves. The use of the DJ Stent can not be separated from the morbidity or complications that might occur, including discomfort arising from the insertion of stents, forgotten to remove, urinary tract infections, biofilm formation, even encrustation of the stent. This research aims to know the correlation between the urine metabolites condition and urinary tract infection in the formation of biofilm and encrustation in patients with urinary tract stones at Saiful Anwar General Hospital, Malang. Method: This is a cohort study using chi-square analysis and relative risk calculation. The datas were obtained from patients at Saiful Anwar General Hospital from March 2016 until December 2017. The examination includes urine metabolites, urinalysis, and urine culture prior to the insertion of DJ Stent, at polyclinic, and before the removal of DJ Stent. After the DJ Stent was removed, we evaluate if there was an encrustation on the DJ Stent or not and biofilm using congo agar plate. The subjects in this research was patient with urinary tract stone and patient without urinary tract stone as control group. Result: There were 60 patients with urinary track stones, as well as 60 patients without a urinary track stone as a control. We found that high level of uric acid prior to removal of DJ Stent and during polyclinic control, and also high level of magnesium urine before DJ Stent removal were five times higher to form biofilm in patients with urinary tract stones. The presence of urinary tract infections when the subject control at polyclinic and before DJ Stent removal, and the presence of bacteria in urine before the insertion of DJ Stent in patients with urinary tract stones is significantly have five times higher risk to form encrustation on the DJ stent. Patients without urinary tract stone have four times higher risk in the formation of encrustation with abnormal level of magnesium that found before the removal of DJ Stent. Delayed in DJ Stent removal in patients without urinary track stone were significantly have ten times higher risk in biofilm formation and six times higher risk in the formation of encrustation in patients with urinary tract stones. Conclusions: There is a relationship between the condition of urine metabolites and urinary tract infections with biofilm formation and DJ Stent's encrustation in patients with urinary tract stones.
Case Series: Iatrogenic Penile Amputation Due to Circumcision
Brawijaya Journal of Urology Vol. 1 No. 01 (2020): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Introduction: Penile amputation is the most common complication of guillotine circumcision. The incidence of penile amputation was highest among males circumcised at 10 years or older There are three cases of iatrogenic penile amputation due to circumcision in Saiful Anwar General Hospital Malang in last 5 years. Case: This series contains three cases of iatrogenic penile amputation due to circumcision in Saiful Anwar General Hospital Malang within 2013-2018 and all of them taken from hospital medical records. One of them already done replantation of penile but unsuccessful due to the preserved of the cutout and the ischemic time of the wound. All of them get injury due to Guillotine technique that performs by the inexperienced people. In cases of a microphallus, buried penis, hypospadias, epispadias, phimosis, and penoscrotal webbing the circumcision should be performed by a surgeon. Conclusion: Guillotine techniques are not safe for patients under 10 years old, because increase the risk of penile injury.
Congenital Urethral Diverticulum With Stone in A 42 Year Old Male Patient: a Case Report
Brawijaya Journal of Urology Vol. 1 No. 02 (2021): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Urethral diverticulum (UD) is a localised out pouching or fusiform dilatation of the urethra. UD commonly found in women and very rare in men. We present a case of 42-years old male suffered from scrotal swelling with hard consistency and lower urinary track symptom (LUTS) for more than 30 years. At first, scrotal mass was suspected as scrotal cancer. An open surgery was perfomed, and a giant stone with diverticulum was found. With limited facilities and the absence of urologist, we performed a stone removal and drainage placement before we referred the patient to urologist for definitive treatment. UD is a very rare case, especially male UD. Doctors and other health workers in rural area must remain aware of rare cases so early diagnosis can be found and further complication can be prevented.
Characteristic of Urinary Tract Stones Patient in Sido Waras General Hospital Mojokerto Kristian Mohamad Daniputra; Antono Pratanu
Brawijaya Journal of Urology Vol. 1 No. 02 (2021): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Introduction & Objectives: Urinary tract stones had been discovered since ancient Egyptian period. In eighteenth century, a Russian scientist H.C.G von Struve discovers struvit stone in which the formation of the stone is initiated by urinary tract infection. Prevalence of kidney stone disease in Indonesia is 0,6% in 2013 and in the United States, incidence of kidney stone disease is 116/100.000 people in 2000. The objective of this research is to determine the characteristic of urinary tract stone patients treated in Sido Waras General Hospital Mojokerto, East Java. Material & Method: The design of this research is descriptive study. The inclusion criteria is all new cases of urinary tract stone treated in Sido Waras General Hospital between 2017 until 2018. All clinical data regarding urinary tract stone disease is obtained from medical record retrospectively. Results: There are 285 new cases of urinary tract stone treated in Sido Waras General Hospital Mojokerto in 2 years, in which 236 cases (83%) are male and 49 cases (17%) are female. Most of urinary tract stone patients are classified in 40-60 years old group with 197 cases in two years. The most common case of urinary tract stone is kidney stone with 147 cases (51%). Open surgery is the most common management which is done for urinary tract stone disease in two years (52%). Based on comorbid disease, there are 120 urinary tract stone patient (42%) suffering hypertension and 84 urinary tract stone patients (29%) suffering diabetes mellitus. Conclusion: The incidence of urinary tract stone in Sido Waras General Hospital is 285 cases. Urinary tract stones are more common in male, with male to female ratio 4:1. The majority of cases are kidney stone.
“Wriggling parasite inside the bladder” : case report in Semarang, Indonesia Yohanes Dona Christi Utama; Dimas S. Wibisono; Yustina Elisa Febriany
Brawijaya Journal of Urology Vol. 1 No. 02 (2021): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Introduction & Objectives: Finding "worm-like" parasite inside human bladder is rare. Most possible causes are parasitic helminths and myiasis. They may cause cystitis and/or urethritis symptoms : dysuria, haematuria, urethral discharge, and abdominal pain. The pathogenicity results from inflammation and toxin secreted by the larvae. Progressive and continuous bladder-wall necrosis may occur associated with larval growth and invasion. Knowing the causal parasite, its clinical manifestation, and the treatment is important to discuss. Material & Method: We present a case report of 60 years-old-man experiencing moving suprapubic pain for a month, especially when urinating (dysuria), and had pinkish urine color. Surprisingly, during performing cystoscopic and bladder evacuation, 2 mm-long worm-like pinkish-white moving object was found inside the bladder. Bloody urine sample was sent to the laboratory but no adequate larvae found in the urine. It made the parasitologists difficult to mention what was the exact species of the larvae. There were pinkish color, microhematuria, and no suspected helminth’s eggs found from urinanalysis. The patient showed better improvements after surgery. His complaints gradually reduced, there was no more hematuria and dysuria. Discussion: Urinary helminth infection leads to permanent urogenital problems, renal failure and malignancy. Echinococcosis creates cysts, Filariasis involves lymphatic system obstruction. Helminths lay their eggs inside the urinary organs and excrete them through urine. These characteristics were not found in this case. Myiasis was more relevant with the involvement of worm-like creature. Microhematuria was found on laboratory examination. Major symptoms were moving abdominal pain with no exact location and pinkish urine. Recommended treatment was to remove the larvae and treat associated infection with antibiotics. Afterwards, there was significant improvement from the patient’s condition. Conclusion: Knowing the urinary tract parasite is important for its treatment. Further studies to analyze the larvae, prevent its infection, and decide the best treatment are necessary.
Nephrolithiasis on The Right Kidney: A Case Report Cindy Marie Agnes Lorenza Aurelia Edon; Ephram Sanders Alfian Siadary; Arley Sadra Telussa
Brawijaya Journal of Urology Vol. 1 No. 02 (2021): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Nephrolithiasis or kidney or renal stone, is a common disease in the World. In industrialized countries, the prevalence of upper urinary tract stones has persistently increased in the twentieth century, yet there are significant contrasts among countries and furthermore inside a similar countries. The case of this Nephrolithiasis on right Kidney was reported at W.Z Johannes Hospital, Kupang, East Nusa Tenggara, Indonesia. The patient is a 64 year old female with right renal stone. The patient came to the ER with complaints of right flank pain and patient complains of hematuria first. Percutaneous Nephrolithotomy (PCNL) surgical procedure was performed to release the stone. Conclusion : The cause of the right renal stone should be considered to treatment as eliminating the cause and the underlying factor will reduce the complications and recurrence rates.
Urethral Catheterization for Urinary Retention in Women
Brawijaya Journal of Urology Vol. 1 No. 02 (2021): Brawijaya Journal of Urology
Publisher : Department of Urology, Faculty of Medicine, Universitas Brawijaya

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Introduction: Urinary retention is the inability to voluntarily pass urine with female:male ratio of 1:13. It may result from obstruction, infection, stenosis, etc. Urinary tract infection (UTI) causes inflammation and swelling of the urethra resulting in compression of the urethra and urinary retention. Objectives: Urinary retention in women is a rare occurrence and thus needs further evaluation. Case Presentation: 54 years old female were admitted to the ER with urinary retention and dull suprapubic pain, she had the history of diabetes and difficulty to urinate since 3 months ago. The bladder was quite distended. Insertion of 16-Fr foley catheter was attempted, and the output was around 20 ml of cloudy-yellowish fluid, with the second attempt of 24-Fr three-way foley catheter, around 1000ml of urine -suggestive of pyuria- was drained. Abdominal USG reported bilateral hydronephrosis, sludge debris in the bladder, and chronic cystitis. Discussion: The etiology of obstruction in this patient is cystitis that associates with diabetic bladder dysfunction. Risk factors for cystitis which we found in this patient are female, post menopause, old age, previous UTI, and diabetes. Diabetes may lead to diabetic bladder dysfunction with impaired detrusor contractility resulting in impaired bladder emptying and elevated residual urine. These conditions may result in chronic cystitis and the buildup of sludge debris on the bladder obstructing the hole of the urethral catheter. Thus, a larger size with a larger hole catheter that can evacuate the sludge debris is needed. Conclusion: In female patients with urinary retention and UTI and failure of urethral catheterization without resistance and contraindications, we recommend using larger size of urethral catheter before suprapubic catheter.

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